1. Field of the Invention
This invention relates to devices for placing sutures to close incisions and more particularly relates to a device and method to efficiently close small incisions used in laparascopic surgery.
2. Background Information
Laparascopic surgical procedures generally use small incisions some 5 to 16 millimeters in length for placement of a cannula and trocar used in laparascopic surgical procedures such as cholecystectomy, herniorrhaphy, Nissen, hysterectomy, colectomy, etc. One method used to close such incisions is by simple surface skin or facial closures. However, a not infrequent problem with this and other methods is that the closures are not affective enough and lead to complications such as hernias and bowel strangulations.
Another method used to close such incisions is by a tedious procedure that requires a surgeon to laparascopically grasp a suture from a closure insertion device after placement through the abdominal wall. The closure insertion device is then withdrawn and then reinserted through the abdominal wall on the opposite side of the trocar site incision. The surgeon must then reinsert the needle into the closure insertion device and then withdraw it creating a loop around the trocar site incision. The tedious part of the process is the need to reinsert the suture into the closed insertion device which sometimes requires a surgeon to "work backwards" depending on the camera location.
Thus there is a need for a simple and preferably disposable device for closure of trocar site incisions used in laparascopic surgical procedures described above. A device that could quickly, efficiently and atraumatically insert sutures to close a laparascopic incision would be advantageous.
There is an existing device called a Brown/Mueller Fastener described in U.S. Pat. No. Re. 34,021 of Peter R. Mueller et al, that is designed to insert a T-bar fastener through the abdominal wall. This device has a needle with a slot in the end for receiving a metal T-bar with a single short suture extending through the slot along the outside of the needle. The needle with the loaded metal T-bar and short suture is then inserted through the abdominal wall. The metal T-bar and attached suture is then extruded from the needle allowing the metal T-bar to fasten the suture inside the abdomen. This device is currently used for securing a portion of an intestine to the abdominal wall for placement of feeding tubes. A disadvantage of this device is that it allows placement of only a single suture which must be securely held by the surgeon while the needle is piercing the abdomen.
It is therefore one object of the present invention to provide laparascopic insertion/closure device that can quickly and efficiently place multiple T-bar sutures on opposite sides of a trocar site incision to close the wound.
Another object of the present invention is to provide a laparascopic incision closure device that can store multiple T-bar sutures inside a housing.
Still another object of the present invention is to provide a laparascopic incision closure device having an ejection mechanism for firing and ejecting one T-bar suture at a time.